title: Mismatches for two major and one minor histocompatibility antigen correlate with a patient's rejection of a bone marrow graft from a serologically HLA-identical sibling.
abstract: We describe the case of a patient with chronic myeloid leukemia who rejected a bone marrow (BM) graft from a sibling donor believed to be HLA identical. Sequencing of the HLA genes showed the mother to be heterozygous for two closely related HLA haplotypes that could not be resolved by serological typing. The donor and the recipient had each inherited a different maternal haplotype resulting in allelic mismatches for the HLA-B35 and the HLA-DR11 genes. T cell cytotoxicity directed towards the donor's B35 allele was detected in the patient, in addition to CTL specificity for an HLA-B7-restricted minor histocompatibility antigen carried by the donor, resulting in three histocompatibility mismatches between the BM donor and the recipient.
authors.affiliation: Department of Structural Biology, Stanford University School of Medicine, CA 94305-5400, USA.
authors.forename: K
authors.initials: K
authors.lastname: Lienert-Weidenbach
authors.forename: N M
authors.initials: NM
authors.lastname: Valiante
authors.forename: C
authors.initials: C
authors.lastname: Brown
authors.forename: C
authors.initials: C
authors.lastname: White
authors.forename: L
authors.initials: L
authors.lastname: Johnston-Dow
authors.forename: M
authors.initials: M
authors.lastname: McGinnis
authors.forename: P
authors.initials: P
authors.lastname: Krausa
authors.forename: D M
authors.initials: DM
authors.lastname: Lakes
authors.forename: J L
authors.initials: JL
authors.lastname: Wolf
authors.forename: K G
authors.initials: KG
authors.lastname: Blume
authors.forename: P
authors.initials: P
authors.lastname: Parham
mesh_terms: D000328:Adult; D000483:Alleles; D016026:Bone Marrow Transplantation / Q000276:immunology*; D002461:Cell Line, Transformed; D004252:DNA Mutational Analysis; D005188:False Negative Reactions; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D015234:HLA-A Antigens / Q000235:genetics / Q000276:immunology*; D059870:HLA-A11 Antigen; D015797:HLA-B35 Antigen / Q000235:genetics / Q000276:immunology*; D015793:HLA-B7 Antigen / Q000235:genetics / Q000276:immunology*; D006684:HLA-DR Antigens / Q000235:genetics / Q000276:immunology*; D059810:HLA-DR Serological Subtypes; D006239:Haplotypes; D006579:Heterozygote; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000276:immunology / Q000628:therapy*; D007959:Lymphocyte Culture Test, Mixed; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D009679:Nuclear Family; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D012008:Recurrence; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D014182:Transplantation, Autologous / Q000276:immunology*
chemical_list: D015234:HLA-A Antigens; D059870:HLA-A11 Antigen; D015797:HLA-B35 Antigen; D015793:HLA-B7 Antigen; D006684:HLA-DR Antigens; D059810:HLA-DR Serological Subtypes; C080766:HLA-DR11 antigen